New Member Form

Company/Organization_____________________________________________________________________
Address________________________________________________________________________________
______________________________________________________________________________________
Member Contact
Name____________________________________Title__________________________________________
Telephone_______________________ Fax_______________________ email________________________
Number of Employees_____

Why are you and your organization interested in becoming DHC members? ______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

Describe your organization's current efforts in the area of diversity ______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

What are your organization's goals with regard to diversity? ______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

Designate membership level. Both levels entitle the member to the benefits of membership, including listing as a member on all DHC literature and the DHC website (www.diversityjobsmaine.org), linking directly to the DHC website, and distributing recruitment materials at job fairs attended by DHC.

______Active Member $150 annual membership fee
(Active members regularly participate in DHC business, including committee work and actively contribute to the development and accomplishment of the DHC annual plan.)

_____Supporting Member $300 annual membership fee
(Supporting members donate financial support to receive member benefits but are unable to provide resources to actively participate in the work of the DHC.)

The Diversity Hiring Coalition of Maine is a partnership of private and public sector employers providing leadership and developing resources to help Maine employers increase, support and retain racial and ethnic diversity in the workplace. Your membership in the DHC requires that you and your organization value and support this mission.

_____________________________________________
Name

_____________________________________________
Title

_____________________________________________
Signature

Enclose check (Made out to Maine State SHRM Council) and
Send New Member Form to:

Diversity Hiring Coalition
P.O. Box 7324
Portland, ME 04112-7324
Attention: Finance


If you have questions regarding membership in the DHC, please contact:
Ken Lewallen -- 207-624-6488